Association of Depression and Suicidality with Electronic and Conventional Cigarette Use in South Korean Adolescents

Abstract

Background: The prevalence of Korean adolescents with depression was 25.1% in 2017, and the suicide rate among Korean teens increased from 4.2 deaths per 100,000 in 2015 to 4.9 deaths per 100,000 in 2016, suggesting that a high prevalence of depression and suicide among adolescents is a serious social problem in South Korea. Owing to the rapid growth of e-cigarettes in the last several years, it is important for research on smoking and mental health to distinguish different uses of tobacco products. Objectives: To examine the relationship between depression and suicidality among Korean adolescents, classified into nonusers, conventional-cigarette-only users, e-cigarette-only users, and dual users. Methods: Data were examined from the 2017 Korean Youth Risk Behavior Web-based Survey. The study included 62,276 students. A multivariate logistic regression was performed to assess the association of depression and suicidality with electronic and conventional cigarette use. Results: There were significant differences among the users: dual users had a higher prevalence of depression and suicidality for both lifetime and current use; e-cigarette-only users had higher levels of depression and suicidality than nonusers; and among female adolescents, conventional-cigarette-only users, e-cigarette-only users, and dual users had a higher prevalence of depression and suicidality than male adolescents. Conclusions: This is the first study to assess the association of depression and suicidality with conventional and e-cigarette use using a nationally representative Korean adolescent sample. These findings suggest an urgent need for evaluation of and intervention for e-cigarette use by health professionals providing smoking cessation programs for adolescents.

Keywords:

• Adolescents
• depression
• dual use
• electronic cigarettes
• smoking
• South Korea
• suicidality

Disclosure statement

The authors report no conflict of interest.

Data statement

The authors confirm that the data supporting the findings of this study are available within the article or its supplementary materials.

Ethics

The study was approved by the institutional review board of the authors’ university (IRB approval no. MC18QESI0030).